Department of Anaesthesiology, The Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China.
Department of Anaesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
BMC Anesthesiol. 2021 Mar 2;21(1):66. doi: 10.1186/s12871-021-01285-x.
Estimating the depth of anaesthesia (DoA) is critical in modern anaesthetic practice. Multiple DoA monitors based on electroencephalograms (EEGs) have been widely used for DoA monitoring; however, these monitors may be inaccurate under certain conditions. In this work, we hypothesize that heart rate variability (HRV)-derived features based on a deep neural network can distinguish different anaesthesia states, providing a secondary tool for DoA assessment.
A novel method of distinguishing different anaesthesia states was developed based on four HRV-derived features in the time and frequency domain combined with a deep neural network. Four features were extracted from an electrocardiogram, including the HRV high-frequency power, low-frequency power, high-to-low-frequency power ratio, and sample entropy. Next, these features were used as inputs for the deep neural network, which utilized the expert assessment of consciousness level as the reference output. Finally, the deep neural network was compared with the logistic regression, support vector machine, and decision tree models. The datasets of 23 anaesthesia patients were used to assess the proposed method.
The accuracies of the four models, in distinguishing the anaesthesia states, were 86.2% (logistic regression), 87.5% (support vector machine), 87.2% (decision tree), and 90.1% (deep neural network). The accuracy of deep neural network was higher than those of the logistic regression (p < 0.05), support vector machine (p < 0.05), and decision tree (p < 0.05) approaches. Our method outperformed the logistic regression, support vector machine, and decision tree methods.
The incorporation of four HRV-derived features in the time and frequency domain and a deep neural network could accurately distinguish between different anaesthesia states; however, this study is a pilot feasibility study. The proposed method-with other evaluation methods, such as EEG-is expected to assist anaesthesiologists in the accurate evaluation of the DoA.
在现代麻醉实践中,估算麻醉深度(DoA)至关重要。基于脑电图(EEG)的多种 DoA 监测仪已广泛用于 DoA 监测;然而,在某些情况下,这些监测仪可能不够准确。在这项工作中,我们假设基于深度神经网络的心率变异性(HRV)衍生特征可以区分不同的麻醉状态,为 DoA 评估提供辅助工具。
我们开发了一种基于时频域中四个 HRV 衍生特征与深度神经网络相结合的区分不同麻醉状态的新方法。从心电图中提取四个特征,包括 HRV 高频功率、低频功率、高到低频率功率比和样本熵。接下来,这些特征作为深度神经网络的输入,利用意识水平的专家评估作为参考输出。最后,将深度神经网络与逻辑回归、支持向量机和决策树模型进行比较。使用 23 名麻醉患者的数据集来评估所提出的方法。
四种模型在区分麻醉状态方面的准确率分别为 86.2%(逻辑回归)、87.5%(支持向量机)、87.2%(决策树)和 90.1%(深度神经网络)。深度神经网络的准确率高于逻辑回归(p<0.05)、支持向量机(p<0.05)和决策树(p<0.05)方法。我们的方法优于逻辑回归、支持向量机和决策树方法。
在时间和频域中纳入四个 HRV 衍生特征和深度神经网络可以准确区分不同的麻醉状态;然而,这是一项初步可行性研究。所提出的方法——结合其他评估方法,如 EEG——有望帮助麻醉师准确评估 DoA。